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양측 슬관절에 발생한 양측 대퇴과의 박리성 골연골염 : 1례 보고 A Case report
나경욱,-- 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Osteochondritis dissecans is an osteonecrotic lesion that affects the subchondral bone and articular cartilage of the joint that lies over it. In osteochondritis dissecans of the knee. the lesion usually is located on the lateral aspect of medial femoral condyle. B lateral lesions occur in 20% to 40% of young patients versus only 5% in the older patients. A case of osteochondritis dissecans of both knee joints is developed in 16 year old boy. The one was treated with arthroscopic antegrade drilling of fragments, and the other treated with non-weight bearing ROM exercise.
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나경욱,박규원 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objectives: To evaluate whether the cartilage damage of joints incumbent in limb lengthening is reversible or not after long bone lengthening using external fixator has been widely usded for limb length equalization. Methods and Materials: Eighty New Zealand White rabbits were performed of surgical division of femur and application of external monofixator to unilateral side(n=75). Lengthening at 10% (n=10), 20% (n=10), and 30% (n=15) over initial femoral length was conducted at a rate of 0.5㎜ per day. X-ray of the limb was checked every week. Three representative sections (one coronal section of femoral head, sagittal sections of distal femur and proximal tibia) were obtained, and all sections were decalcified and embedded in paraffin, and stained with hematoxyline-eosin and safranin-O. Cartilage change was examined grossly and microscopically, and their thickness was also measured. Results: Observations were made as follows, 1. Ten rabbits with 10% lengthening (group Ⅰ) were subgrouped and no conceivable articular change was noted 2. Ten rabbits with 20% lengthening (group Ⅱ) were subgrouped group Ⅱ-a showed no significant changes where as group Ⅱ-b(n=5) did show 2 cases to be grossly changed and moderate microscopic changes, 3. Fifteen rabbits with 30% lengthening (group Ⅲ) were subgrouped. Gross change was negligible in group Ⅲ-a, but it was evident in both group Ⅲ-b and Ⅲ-c. Microscopic change was noted in all groups. Conclusions: As a conclusion, degenerative change of articular cartilage associated with bone lengthening appeared related with amount of lengthening and duration of the given conditions. Critical range was 20% for lengthening amount and 2 months for duration in terms of reversibility of cartilage change in distal femur of rabbits.
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전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술
나경욱,정병현,서진수,석승엽,박규원,채동주,Nha Koung Wook,Jung Byung Hyun,Suh Jin Soo,Suk Seung Yeub,Park Gyu Won,Chae Dong Ju 대한관절경학회 2002 대한관절경학회지 Vol.6 No.1
목적 : 전위된 경골 과간 융기부 골절시 슬개골 하단을 통한 삽관 나사못 고정술의 효용성을 분석하고자 한다. 대상 및 방법 : 1998년 12월부터 2001년 5월까지 성인에서 전위된 경골 과간 융기부 골절을 관절경의 도움 하에 슬개골 하단을 통한 삽관 나사못 고정술을 시행하고 1년 이상 추시가 가능하였던 10예를 대상으로 임상적 및 방사선적 결과를 분석하였다. 결과 : 모든 예에서 골유합을 얻었으며 방사선적 골유합은 평균 9.2주였다 최종 추시시 전방 전위는 전방 stress 방사선상 평균 1.8 mm를 보였으며 KT-2000 arthrometer에서는 평균 1.1 mm였다. 신전 제한은 평균 4.1도를 보였다. 기능적 결과는 우수가 7예, 양호가 3예로 모두에서 만족할만한 결과를 보였다. 결론 : 성인에서 전위된 경골 과간 융기부 골절시 관절경적 수술 방법인 슬개골 하단을 통한 삽관 나사못 고정술은 슬개골 하단의 비관절면을 통하여 삽관 나사못을 고정함으로서 정확한 정복과 견고한 고정을 얻을 수 있었으며, 술 후 조기에 능동적 관절 운동을 허용할 수 있어 간편하면서도 유용한 수술방법이라 사료된다. Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.
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주석규,김병직,정병현,서진수,나경욱,김진환,조진호,석승엽 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objectives: The object of this study is to evaluate the type and treatment of elbow fractures in children. Materials and Methods: A clinical analysis was performed on 147 pediatric patients with elbow fractures from December 1999 to May 2001 who were followed up for more than one year. Results: Fractures of supracondylar in children was most common injuries of the elbow in 80 cases(54%). The most common mechanism was fall from height in 115(78%). The most common place of trauma was playground in 125(85%). Conclusion: The elbow fractures in children are extremly common and sometimes quitedifficult todertermine thediagnosis. Failure to diagnose adequately andtreat fractures of the elbow in children may result in severe complications, such as Volkmann' sischemic contracture, never injuries and angular deformity. Therefore, accurate diagnosis and reduction without additional trauma and good maintenance are essential by closed or open method.
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